Blood flow and metabolic health
Atherosclerosis, hypertension, diabetes, excess weight and smoking can impair the vessels involved in erections. These risk factors also matter beyond sexual health.
Nerves, hormones and anatomy
Neurological disease, spinal or pelvic injury, surgery, low testosterone in selected cases and penile curvature may contribute. Symptoms such as numbness, pain or a new bend need direct assessment.
Medicines and substances
Some antidepressants, blood-pressure treatments, sedatives and other products may contribute. Alcohol and recreational substances can also affect response. Never stop a medicine without the prescriber’s advice.
Mind and body are not separate lanes
Stress and anxiety can intensify a physical problem, while repeated physical difficulty can create anticipatory anxiety. A combined plan is often more realistic than choosing a single cause.